Why Equal A1c Results can be Very Different
Hemoglobin A1c (A1C) has been considered the clinical standard for determining overall glycemic control. Although valuable as a long-term glycemic measure, A1C does not expose day-to-day and intra-day blood glucose (BG) fluctuations. It does not show short-term glucose exposure, glucose variability or episodes of low or high glucose. This is part of the reason Why Equal A1c Results can be Very Different.
This reveals well the importance of good blood glucose control at all times, and that HbA1c results by themselves can be misleading.
A recent post to a Facebook page I follow said this:
The Diabetes Health magazine published an article stating that diabetics should maintain a good BG average and A1c, and avoid a roller coaster type of control. The roller coaster type of control involves having many highs and lows, and that would involve data widely scattered above and below the average. Blood sugars that rise and fall, like the path of a roller coaster are a shock to the body. Experiencing this shock over a long period of time can lead to diabetes related complications, even if the A1c is good. I will demonstrate with two examples.
Patient ‘A’ has BG test results of 40, 55, 65, 100, 135, 145, and 160. The average is 100, but these numbers include several unhealthy highs and lows.
Patient ‘B’ has test results 72, 80, 94, 100, 106, 120 and 128. The average is again 100, but the data is more closely packed. Patient B is experiencing much better control, and is much less likely to have diabetes complications.
A very good BG average can still involve diabetes complications if there is a significant number of highs and lows over a long period of time. Don’t rely solely on a blood sugar average and A1c. Try your best to avoid highs and lows. A good average accompanied by stable control is the best way to avoid complications. Proper dieting and well-chosen exercise routines can help very much in avoiding the highs and lows.
Health-e-Solutions comment: Our boys have had remarkably stable BG levels along with A1cs under 5.0. We attribute this to implementing the diabetic-alkaline lifestyle upon diagnosis, and sustaining it over the last 4 years.
Self-monitoring of blood glucose is an important adjunct to A1C measurements, offering identification of hypoglycemic episodes and a distinction between fasting, pre-prandial and postprandial hyperglycemia.
The clinical relevance of identifying and treating hypoglycemia, postprandial hyperglycemia and glycemic variability becomes increasingly significant as studies expose the correlation between unresolved or escalating glycemic abnormalities and diabetes-related diseases.
Mapping, monitoring and measuring are a continuous cycle when living with diabetes. You begin with a certain course of treatment in mind, which you mapped out with the help of your medical professional. You monitor your progress and measure it against your goals. Upon evaluation, you may find a new course must be corrected to compensate for successes and challenges. Evaluating progress and results of the Health-e-Solutions lifestyle is essential for mastering diabetes in the healthiest way possible. This 124-page downloadable e-publication equips you with the key evaluation tools you need, along with some of the research behind them, to determine where you want to go and how to get there. We give you important tools to help you chart your course and stay on track to reach your destination.